BOULEVARD DENTAL CLINIC (NPI# 1639346182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639346182 |
| Entity Type | Organization |
| Organization Name | BOULEVARD DENTAL CLINIC |
| Other Organization Name | DR RICARDO M GAITAN DDS/PC |
| Practice Address |
8301 Arlington Blvd Suite #403 Fairfax VA 22031-2902 |
| Practice Telephone | 7032060466 |
| Practice Fax Number | 7032060479 |
| Mailing Telephone | 7032060466 |
| Mailing Fax Number | 7032060479 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | DR. RICARDO MOISES GAITAN (GENERAL DENTIST) |
| Authorized Official Telephone | 7032060466 |
| Authorized Official Credential | DDS/PC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
0401008771 | VA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dr Ricardo M Gaitan DDS/PC | Other Name - Individual/Organization |
| Street Address |
8301 ARLINGTON BLVD SUITE #403 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154309136 | Marcie K. Weil | Pediatrics | 8301 Arlington Blvd, Suite 209, Fairfax, VA 22031-2902 | 2006-01-09 |
| 1144769639 | Evelyn T Samuel Dmd PC | Dentist | 8301 Arlington Blvd, Ste. 207, Fairfax, VA 22031-2902 | 2017-02-16 |
| 1619328416 | Loretta Jean Vece | Nurse Practitioner | 8301 Arlington Blvd, Suite #305, Fairfax, VA 22031-2902 | 2016-06-23 |
| 1548640287 | Gina Decaro | Physical Therapist | 8301 Arlington Blvd, Suite 209, Fairfax, VA 22031-2902 | 2015-06-08 |
| 1063813442 | Dr. Zhou's Clinic, Pllc | Exclusive Provider Organization | 8301 Arlington Blvd, Suite 309, Fairfax, VA 22031-2902 | 2014-09-04 |
| 1568879682 | Lng Associates, Pllc | Obstetrics & Gynecology | 8301 Arlington Blvd, Suite 206, Fairfax, VA 22031-2902 | 2014-07-21 |
| 1821423666 | Alka Mahajan | Dentist | 8301 Arlington Blvd, Suite T-2, Fairfax, VA 22031-2902 | 2013-09-11 |
| 1104194570 | Fairfax Pulmonary & Critical Care Group LLC | Internal Medicine | 8301 Arlington Blvd, Suite T5, Fairfax, VA 22031-2902 | 2011-12-13 |
| 1881981702 | Robert Weldon Crawford | Physical Therapist | 8301 Arlington Blvd, Suite 209, Fairfax, VA 22031-2902 | 2011-06-29 |
| 1306136056 | Megan Marie Mccahey | Counselor | 8301 Arlington Blvd, 304, Fairfax, VA 22031-2902 | 2011-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053873240 | Merrifield Dental Associates | Clinic/Center | 3025 Hamaker Ct Ste 420, Fairfax, VA 22031-2237 | 2019-04-05 |
| 1790124949 | Georges Traboulsi Dds PC | Clinic/Center | 3946 Kathryn Jean Ct, Fairfax, VA 22033-2739 | 2013-06-20 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1023287737 | Naturadent, P.C. | Clinic/Center | 9508a Lee Hwy, Fairfax, VA 22031-2303 | 2008-02-27 |
| 1932292877 | William B Sherman Dds PC | Clinic/Center | 9500 B Lee Highway, Fairfax, VA 22031 | 2006-10-02 |
| 1205897378 | Spencer B Wagner Dmd PC | Clinic/Center | 1987 Allendale Fairfax Hwy, Fairfax, SC 29827-9137 | 2006-03-29 |
| 1710477815 | Pd Dental Pllc | Clinic/Center | 10721 Main St Ste 100, Fairfax, VA 22030-6913 | 2018-05-14 |
| 1831606086 | Jhia-ming Chang, Dds, PC | Clinic/Center | 11208 Waples Mill Rd Ste 100, Fairfax, VA 22030-6077 | 2018-01-09 |
| 1336661651 | Jones Family Dentistry Pllc | Clinic/Center | 3879 Plaza Dr, Fairfax, VA 22030-2512 | 2017-07-07 |
| 1518330133 | Optimal Dental Center, Inc | Clinic/Center | 8303 Arlington Blvd, Suite 107, Fairfax, VA 22031-2903 | 2015-11-04 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.